HomeMy WebLinkAboutPermit Renewal RequestVol
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2360 VIRGINIA AVE FRECE17FORT PIERCE, FL34982(772) 462-1553 Fax (712) 462-1578
PERMITRENEWAL REQUEST' sT. Lucie.County, permitting
77TNUMBER:ev�
0 J V V 1 ADDRESS: VI i� /, I `-�t 3q(0I,, am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE. TIME RENEWAL and the permit shall expire should I not receive a
.passing inspection during any six month period during the renewal period.
Justific tion e�(. i
(�S 1� t&C-2 kfule-i 0.uv, ft v _ 1 VISU
10-11-1g
DATE
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS , DAY OF CJ C. A 20
BY 'S o 4 r G '� 'WHO IS PERSONALLY KNOWN TOME , OR
HAS PROVIDED t- AS IDENTIFICATION.
TE OF FLORIDA, County o )C L %) c. l
FOR OFFICE USE ONLY:
_-0�NAMARIE GIVENS
MY COMMISSION # GG 022023
EXpIRES:Decep bllcUndanvntsr
16,2020
Bonded Tnriiii '_
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x %.open = $ Renewal fee
Example: (15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised W212014